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Canadian Journal of Infectious Diseases
Volume 11, Issue 4, Pages 193-201
Original Article

Hospitalization due to Adverse Drug Reactions and Drug Interactions before and after HAART

Michelle M Foisy,1 Kevin Gough,2 Corinna M Quan,3 Kevin Harris,4 Dominique Ibanez,5 and Anne Phillips6

1St Michael’s Hospital, The Wellesley Health Centre and University of Toronto, Ontario, Canada
2Infectious Diseases and HIV, Inner City Health Program, St Michael’s Hospital and University of Toronto, Ontario, Canada
3Infectious Diseases, St Michael’s Hospital, Wellesley Central Site, Canada
4Emergency Department, St Michael’s Hospital, Wellesley Central Site, Toronto, Canada
5Ibanez Consulting, Etobicoke, Canada
6HIV Program, St Michael’s Hospital and University of Toronto, Toronto, Ontario, Canada

Received 29 April 1999; Accepted 30 July 1999

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVE: To characterize and compare the rates of adverse drug reactions (ADRs) and interactions on admission in two, one-year periods: pre-highly active antiretroviral therapy (HAART) (phase 1) and post-HAART (phase 2).

DESIGN: Retrospective chart review.

SETTING:University-affiliated tertiary care centre.

POPULATION STUDIED: HIV-positive patients admitted to hospital.

MAIN RESULTS: In phase 1, 436 of 517 admissions, and, in phase 2, 323 of 350 admissions were analyzed. Over 92% of patients were male, with a mean age of 38 years. Significant differences (P<0.05) in the mean length of stay (12.08 versus 10.02 days), the CD4 counts (99.25 versus 129.45) and the number of concurrent diseases (4.20 versus 3.63) were found between phase 1 and 2, respectively. The mean number of medications taken (5.52 versus 5.94) and the rates of hospitalization with ADRs (20.4% versus 21.4%) or interactions (2.5% versus 2.16%) were similar between the two phases. Antiretrovirals were more common in ADR admissions post-HAART (21.3% versus 36.2%), while antiparasitics, psychotherapeutics and antineoplastics were more common pre-HAART. Other classes of drugs involved in both phases were sulphonamides, narcotics, ganciclovir, foscarnet, antimycobacterials and antifungals. ADR causality was possible or probable in more than 80% of cases. Over 60% of ADRs were grades 3 to 4, and about 85% were either the main or contributing reason for admission. About 65% of patients had at least partial recovery at the time of discharge. In phases 1 and 2, 8.9% and 2.9% of admissions,respectively, with ADRs were fatal.

CONCLUSIONS: Although hospitalizations with ADRs and interactions were similar in both phases, HAART therapy has had a significant impact on the incidence and nature of ADRs at St Michael?s Hospital, Wellesley Central Site, Toronto, Ontario.